Provider Demographics
NPI:1669059085
Name:NATIONAL TESTING SERVICES LLC
Entity type:Organization
Organization Name:NATIONAL TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANAYEAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:LAB DIRECTOR/LRT/CMA
Authorized Official - Phone:601-383-4546
Mailing Address - Street 1:1520 ADELINE ST STE B
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-6265
Mailing Address - Country:US
Mailing Address - Phone:601-564-8632
Mailing Address - Fax:601-336-7185
Practice Address - Street 1:1520 ADELINE ST STE B
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6265
Practice Address - Country:US
Practice Address - Phone:601-564-8632
Practice Address - Fax:601-336-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS25D2192934Medicaid